A Personal Story from the Spectrum

5 years ago, I started on the journey of medical school. For me, it was a clean break and freshstart; a chance to remake myself and find my own milieu, one where I could be myself and start to enjoy and indeed live life.

Up until then, my schooling experience had been less than enjoyable. Not so much the actual schooling; I have been fortunate in my life that I attended schools which exhibited an array of academic opportunities with which to explore and take interest. This is not to say I did not struggle against the systems of education which arbitrarily defined what proper teaching and learning meant. Exams were a particular bugbear of mine and they continue to be. My poor parents would feel the brunt of this especially during parent’s evening, when my exasperated teachers would show them my exam papers, which would be purposefully done to incompletion.

The trouble was I did not innately see exams as a way of demonstrating evidence of my learning. I could not understand why it needed to be done or what the actual purpose of marks and grades were. It was a part of a social contract between pupil and teacher I did not comprehend. To me, they were nothing but a series of puzzles, puzzles which I would only answer if I found them of particular interest or challenge. Otherwise, I would just leave it blank as it was pointless to me.

But the purpose of school, is not just academia and its exams, there are both social and physical components; it is the ground zero for picking up social skills and understanding how we relate to each other, as well as the basics of various sporting activities, activities which would build upon learnt social and innate motor skills. I had my own problems with sports: my general lack of proprioception, especially when I was not actively concentrating on it was not helpful. Add on the nature of sporting events as generally being conducted in noisy and bright environments, both elements of which made it harder to concentrate and generally set a sense of discomfort within the tranquillity of my mind, and you had a recipe for a disastrous level of motor skills and clumsiness.

As for the social side, it was trial and error. A lot of trial. A lot of error. The entirety of socialisation, from the unwritten rules that govern our interactions, to the unspoken social cues, to understanding the nuances of speech and knowing when to take meanings literally or read in between the lines; they were a complex tangle of incomprehensible messes that I felt I was banging my head against over and over.

It could be as simple as getting asked “How are you?”. Of course, the answer that people are expecting is supposed to be along the lines of “I’m fine”. It is just a politeness. A way to get the conversation started, a generic platitude of friendliness. But to me, I felt this to be disingenuous. I would not ask someone how they are, unless I truly wanted to know the answer, whether that be that they are on top of the world or in the depths of depression. I would want to know the truth, or I would not have asked. This of course is part of the art of small talk, a concept I struggle with, but have learnt over time and employ for the sake of ease and reduction in awkwardness, although in general, I prefer to say little unless I have something I deem of value to say.

And then there is the more extreme side: unstructured parties/ group gatherings. A complete chaos chasm of unspoken and subtle cues filled with many micro-interactions all happening simultaneously with varying social dynamics in play and signals flying around like its Heathrow airport’s pre-COVID air traffic control. In short, a Gordian’s knot, and I am no Alexander the Great.

In 2017, I got my diagnosis, and it took 3 years from then for me to begin to come to terms with it. At the time, it was a comfort as it gave me a label with which to define my struggle, but it was also a reminder that there are no easy solutions and there was an anxiety associated with the stigma of having a neurodevelopmental ‘disorder’.

While there have been advantages to masking, and I have picked up habits and behaviours that have been incredibly helpful, I find that in continuously and routinely deploying it that I hide that part of myself away, so much so that it becomes a source of angst and shame. A weakness borne from my own actions. I have come to realize that it is only in being true to myself that I can turn it into a strength, for is not our diversity in thought and mind the foundation for our accomplishments in the worlds of art and science?

I hope that during this week, you may have related to some of the experiences being told and have come to understand that although it is given the banner of a singular block diagnosis, the cumulation of experiences of the same condition are vast and incalculable. I have given a glimpse, a few snapshots, into my struggles and experience, and I hope that in reading through them, as well as the other stories from the spectrum, you will be more able to empathize as medical professionals with your patients and, indeed with people in general life.

And for those of you who are like me, who have been silently struggling onwards, camouflaged in the thickets of society, and persevering on: you are not alone. And you are not wrong for being you. Accepting yourself as you are is incredibly difficult. But I want to leave you with the words of the great Roman Emperor Marcus Aurelius: “The impediment to action advances action. What stands in the way becomes the way.”